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Indonesia began deploying a COVID-19 vaccine in January 2021, prioritising vaccination for high-risk groups such as healthcare workers, the elderly and those with comorbidities, and ending with the general public due to limited vaccine availability. Our study aimed to evaluate antibody response in Indonesians who had received two doses of the vaccine vs. those who had not. The study design was a cohort study involving 46 unvaccinated people and 23 people who had received the second dose of the AstraZeneca vaccine in three months. Methods used for the qualitative and quantitative detection of IgG antibodies included rapid RI-GHA and ELISA tests. Findings showed that positive IgG antibodies qualitatively detected by the rapid RI-GHA test were significantly higher in those vaccinated (60.9%) than in unvaccinated people (26.1%). Using the ELISA assay, all vaccinated individuals qualitatively showed positive antibodies (cut-off ≥4.33 BAU/ml), and the average quantitative titer of anti-SARS-CoV-2 s-RBD IgG was significantly higher in vaccinated (157.06±238.68 BAU/ml) than in unvaccinated (51.90±87.60 BAU/ml) individuals. Some unvaccinated individuals with no history of infection were found to have anti-SARS-CoV-2 antibodies that may have been previously asymptomatic, although their mean antibody titers were certainly lower than those in the 2-dose group. Approximately 56% of vaccinated individuals had antibody titers above 60 BAU/ml as a cut-off for protective threshold, a significantly higher proportion than unvaccinated individuals. In conclusion, vaccination with two doses AstraZeneca increased anti-SARS-CoV-2 antibodies which resulted in enhanced immunity against symptomatic COVID-19. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19) is significant global treat including to pregnant woman in Indonesia. A point-of-care diagnostic tool that is able to early diagnose and hasa good sensitivity and specificity is critical during the pandemic. The aim of this study was to describe the clinical, laboratory and outcomes of pregnant women with presumptive COVID-19 and to compare the sensitivity and specificity between COVID-19 rapid test (lateral flow immunoassay) and real-time reverse transcription polymerase chain reaction (RT-PCR). Pregnant women with presumptive COVID-19 symptoms were recruited at Arifin Achmad General Hospital between April 2020 and December 2020. Demographic and clinical data were collected and patients were tested with COVID-19 rapid test as well as RT-PCR. Analyze was conducted to determine the sensitivity and specificity. We included 120 patients with presumptive COVID-19 of which 48 (40%) and 72 (60%) of patients were reactive for IgM and IgG antibody anti severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), respectively and 51 (42.5%) were reactive for both IgM and IgG. The sensitivity and the specificity of rapid test was 64.0% and 33.3%, respectively. The positive and negative predictive value was 61.5% and 35.7%, respectively. In conclusion, lateral flow immunoassay-based rapid test has relatively low sensitivity and specificity in diagnosing COVID-19 in pregnant women. [ABSTRACT FROM AUTHOR]

Background: Rapid molecular diagnostics have potentially revolutionized early detection of drug-resistant tuberculosis (DR-TB) in Indonesia. However, there is discordance between conventional culture using drug susceptibility test (DST) and rapid diagnostic tools using GeneXpert and line probe assay (LPA). This discordance result can cause confusion to clinician in determining diagnosis of DR-TB. Objective: This study aimed to identify discordance between GeneXpert, LPA, and DST. Methods: A retrospective study was conducted at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. Data were collected based on medical record between third to fourth quarter of 2018. Rifampicin resistant-tuberculosis (RR-TB) proven by GeneXpert, were further analyzed with second-line LPA and DST. Discordance result between it was analyzed using McNemar. Results: Among 81 patients diagnosed with DR-TB, 59 patients RR-TB were eligible in this study. There were 13 (22.0%) DST rifampicin result showed sensitive but resistant to GeneXpert. Among 53 samples from LPA, there were 3 (5.7%) result showed LPA fluoroquinolone resistant but sensitive to DST ofloxacin; 10 (18.9%) result has LPA fluoroquinolone sensitive but resistant to DST ofloxacin; 2 (3.8%) has LPA second-line injectable drug (LPA SLID) resistant but sensitive to DST kanamycin; 5(9.4%) has LPA SLID sensitive but resistant to DST kanamycin. The McNemar analysis showed discordance between GeneXpert and DST rifampicin was 13 (22.0%; p=0.046); LPA fluoroquinolone and DST ofloxacin was 13 (24.6%; p=0.042); LPA SLID and DST kanamycin was 7 (13.2%; p=0.183). No variable that can be used to analyze discordance result between GeneXpert and LPA. Conclusion: There is significant discordance between GeneXpert and DST; LPA fluoroquinolone and DST ofloxacin, while neither LPA SLID nor DST kanamycin shows no significant discordance. [ABSTRACT FROM AUTHOR]

Background: Accurate HIV diagnosis is essential for appropriate patient care. Rapid tests (RTs) are considered key to HIV screening and management. Some studies have found RTs to be comparable with the ELISA test whilst others have reported lower sensitivity. Aim and study design: The aim of this retrospective, descriptive study was to evaluate the sensitivity and specificity of the HIV 1/2/O Tri‐line rapid test (HIV‐TRT) device compared with ELISA. Method: The study sample comprised 45 records of patients who tested for HIV using the HIV‐TRT device and ELISA. Results: As compared with ELISA as the 100% gold standard, the sensitivity of the HIV‐TRT was 80% (CI: 59%–93%) and specificity was 100% (CI: 83%–100%). ROC area of 0.9 at 95% CI was determined. Conclusion: The low sensitivity of HIV‐TRT is a concern, since HIV screening in South Africa makes use of RTs. [ABSTRACT FROM AUTHOR]

We recently reported a new rapid screening method for glucose-6-phosphate dehydrogenase (G6PD) deficiency. This method incorporates a new formazan substrate (WST-8) and is capable of detecting heterozygous females both qualitatively and quantitatively. Here, we report its evaluation during field surveys at three malaria centres and in malaria-endemic villages of Myanmar and Indonesia, either alone or in combination with a rapid on-site diagnosis of malaria. A total of 57 severe (45 males and 12 females) and 34 mild (five males and 29 females) cases of G6PD deficiency were detected among 855 subjects in Myanmar whilst 30 severe (25 males and five females) and 23 mild (six males and 17 females) cases were found among 1286 subjects in Indonesia. In all cases, severe deficiency was confirmed with another formazan method but due to limitations in its detection threshold, mild cases were misdiagnosed as G6PD-normal by this latter method. Our results indicate that the novel method can qualitatively detect both severely deficient subjects as well as heterozygous females in the field. The antimalarial drug, primaquine, was safely prescribed to Plasmodium vivax-infected patients in Myanmar. Our new, rapid screening method may be essential for the diagnosis of G6PD deficiency particularly in rural areas without electricity, and can be recommended for use in malaria control programmes. [ABSTRACT FROM AUTHOR]

Indonesia is hyper-endemic for dengue. Dengue virus non-structural protein 1 (NS1) antigen detection is now increasingly used by clinicians in Indonesia to confirm dengue infection, but many available brands have not had any evaluation on their performance. We evaluated the diagnostic accuracy of 5 different brands of NS1 rapid tests against reference standards consisting of 100 virologically confirmed dengue samples covering all 4 serotypes and 49 non-dengue samples. These rapid tests had sensitivity ranging from 73% to 80%, and specificity of 100%. The tests had better sensitivity for detection during the first 4 days of fever, for DENV-3 serotype, and in primary infections. The evaluated tests can be easily used with adequate sensitivity, very good specificity, and no significant difference in performance between brands. However, certain characteristics such as age, fever day onset, serotype, and immunologic status may affect the accuracy of these tests and need to be taken into consideration. [ABSTRACT FROM AUTHOR]